Wednesday, December 26, 2012

Does Anybody Care When There Isn't A Shooting?

Yet another article documenting our failed mental healthcare system! It's interesting that the only time this seems to come up is after some horrible act perpetrated by someone who is or is presumed to be mentally ill. Will we ever care at any other time? Probably not.

Why? Lots of reasons.

Mental health doesn't have the cachet or constituency of other causes, e.g., breast cancer. The mentally ill don't vote. Prisons are seen as popular job creators in the public sector and increasingly as profit creators in the private sector. Mental health facilities and services are seen as drains on the taxpayer and are often first to be cut. The people who provide the bulk of mental health care at all levels - psychologists, social workers, and counselors  - and the services they provide - psychotherapy - are devalued in the mental health system. Name another profession that is paid less in real (not inflation adjusted) dollars than it was in the 1980's for the same or more work. The mental health system - like the rest of health care - is fully controlled by insurance and pharmaceutical industries totally uninterested in prevention or in any treatment - no matter how effective - other than proprietary drugs.

Combine all this with the failure of deinstitutionalization, primarily because it was not properly implemented or  funded, and you get what we have now - a system that simply does not work. Not for the severely mentally ill or their families. Not for those whose problems cause them great suffering even when not considered severe (most depression and anxiety, addiction.) Not for those who develop or experience worsened physical illnesses as a result of psychological stressors (chronic pain and physical disability, obesity, exacerbated morbidity inphysical illnesses.) Not for the citizen/taxpayer who ultimately pays for everything anyway. Not for society as a whole.


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